Shopping has become ever more challenging during this time of COVID. We have all found some of our store’s shelves unusually empty, our favorite brands unavailable, and even some everyday household items into a forced limited quantity permitted (think toilet paper). And now, with the increased availability of COVID-specific products, we are developing a new vocabulary and education. We are using 70% alcohol-based hand sanitizer and looking for N95 masks. What’s our latest shopping list addition? Home COVID Tests.
Like many other communicable diseases, the COVID-19 virus spreads from one individual to another, most often from airborne particles. Individuals can have many symptoms or none at all and still be contagious for many days. This is why it is so critical to have testing available, to provide a means of knowing who is actively carrying the virus. Many healthcare providers and local community healthcare services offer in-office testing, often by appointment. We can now purchase home self-testing kits at major pharmacies and many retail stores. The FDA has authorized several products. Please remember that testing for the virus is not a substitute for prudent actions seeking disease prevention: receiving a full course of vaccination and booster, mask wearing, social distancing, and good hand-washing hygiene.
Let’s explore the different types of available tests, by their science, their expected efficacy and finally just how to use them correctly. As a nurse for over 4 decades, one of the most consistent and seemingly never ending advances have been products and education for my patients to perform tests and treatments at home, with little professional education and no professional assistance. We must be sure these are performed well, and that begins with quality products, then education and ends with accurate performance.
What are the different types of COVID-19 tests?
There are basically two types of tests routinely conducted looking for the presence of the COVID-19 virus. The viral test, sometimes referred to as the molecular or the antigen test, tries to answer your important question: Do I currently have an infection with the virus SARS-CoV-2 that causes COVID-19? The antibody or serological test seeks to answer your other question: Have I previously had an infection with the virus SARS-CoV-2 that causes COVID-19?
What are the different ways to conduct home tests?
Currently there are two ways to conduct your home test: collection only or collection and testing. The home collection test provides the instructions and materials necessary to collect your sample. The process continues as you send the sample to a laboratory as instructed, for their analysis. This specimen is using the PCR test and the individual needs to wait one or more days for the result. The home testing kits provide all the instructions and information for you to complete the process, wait the designated amount of time, and see your results.
Are there different levels of accuracy in these tests?
Yes. The method of specimen collection (nasal canal, higher in the nasal canal, saliva) as well as the site of analysis, home or laboratory, create many of these differences in accuracy. Generally speaking, laboratory-based NAATs are considered to offer more sensitivity than self-administered home-based tests. Many healthcare providers consider the use of a laboratory-based tests as a means of confirming a positive home-based result.
What’s the accuracy of at-home COVID test kits?
Experts have informed us that the most accurate test for the diagnosis of COVID-19 is the Polymerase Chain Reaction (PCR) test. This form of test is not approved for at-home use. We must conclude that at home self-tests are simply not as accurate as a PCR test conducted in a healthcare laboratory. One principle reason for this lesser accuracy is that home tests require a larger amount of virus to be present in your sample in order to report a positive result. Individuals who are tested early during their course of an active case of COVID-19 may not have a high enough level to be detected in a home based test.